Tuesday, October 18, 2011

Were my cesareans necessary? What steps I will take to decrease the chance of another one.

I have been doing a lot of thinking about necessary cesareans lately. I had posted something in a birth group that I belong to on Facebook in response to someone's question about long labors and positioning of babies. A midwife posted back that it sounded like my cesareans were necessary. This felt strange to hear from a group that seems so natural based. It made me step back and really analyze every detail that led up to my cesareans. After thinking about it for days I responded back to that midwife with a brief summary of why I felt they weren't necessary, although in the exact moment without taking what had happened all throughout labor into consideration I did feel like one of them may have been necessary.

Let me explain. My pregnancy with Brayve went well after I got out of the first trimester. He was always moving and had a strong heartbeat. I took the labor and birth class from the hospital that I was going to deliver at. I read the book that was lent to me, "What to Expect When Expecting." I went to the first and actually only OB that I knew. That was about all I did to educate myself on labor and birth. I didn't think twice about pain medication, epidurals, or cesareans. I was going to have a natural, normal birth with my husband and mother there to join in the miracle of watching my son be born. Nothing went as planned. My labor with him was exhausting, frustrating, stressful, and confusing. I never saw the OB throughout my labor, my husband was exhausted and confused as I was, my mom had no information to give because she had birthed in the 80's with a great family practitioner that had faith in her ability to birth her babies. I saw three nurses throughout my hospital stay. The first could barely speak english and was really frustrated with me every time I asked her to repeat herself. The second was very sweet, upbeat, and friendly but didn't offer any knowledge on what was going on because her job was to take care of my medical needs. The third nurse was nice, but quiet, and I felt like she was annoyed with me. After 49 hours of labor the OB finally walked in and said, "you need a cesarean." At that moment I felt like I knew absolutely nothing and the OB was king of the world. He was knowledgeable, experienced, and I was there to be a good patient and do what he says. Despite the profanities that I was throwing out I did do what he said and went in for the cesarean. Afterwards I found out that Brayve was posterior with a large head. That was all of the information I was given. When I found out I was pregnant with Glory I just had faith that she would not also be posterior and I would get a doula in case she was. The doula I chose was the only one I knew and she taught childbirth education classes at the hospital. I chose a different care provider which was a group of midwives instead of a very busy OB from the clinic next door from the hospital. My plan was to labor at home as long as possible because by that point I was terrified of going to the hospital. I once again was planning an all natural birth with no medication and no cesarean. At 37 weeks I found out I had tested positive for the Group B Strep bacteria. They told me that when I went into labor to come into the hospital as soon as possible for penicillin to be administered every 4 hours. I did my research and made the educated decision to go against the midwives advice. Unfortunately my doula was also a nurse and could not help me in my own home. After a good 24 hours of laboring at home my water broke and I was saying the famous phrase, "I can't do this anymore." When we went to the hospital I was told there was meconium in the amniotic fluid. BUT I was dilated 7cm!! Unfortunately I panicked and I think I would have gnawed my own hand off if it meant I could go home and the pain would go away. After being at the hospital for about 7 hours stuck at 7cm and then down to 6cm I started running a fever. Because of the meconium and my fever I was worried for my baby. I went with the midwives advice and opted for the cesarean. In that circumstance at that very moment I honestly do believe that the cesarean was necessary. A newborn with an infection is a very serious and life threatening matter and I wasn't about to toe that line.

This is my take on my first cesarean. I had very little education. I had no knowledgeable support. I read a book about pregnancy and birth that if wasn't borrowed I would use for firewood. I knew nothing about positioning of a baby or even what my baby's position was! I had a very bottom of the line OB who did a huge botch job on my incision. I do not believe at all that the cesarean was necessary. I believe that there were a lot of things I could have done prior to labor starting and also during labor that could have helped that baby turn if I would have known that he may have been or was in an unfavorable position. Putting all that aside though, my epidural was wearing off and I was then told that the baby was posterior. I called my childbirth educator and she said I could try getting on my hands and knees. Brayve's heartbeat was great, and my blood pressure, temperature and stats were also good. I didn't know what to do and neither did my mom and husband. I had a cesarean because I had been there too long. If I had been with a midwife who was knowledgeable of the spinning babies techniques, or who had the patience and interest in helping me figure out why I was laboring so long and why my contractions were so irregular the scenario might have been completely different.

My take on my second cesarean is much the same as my first. If I had been with a more natural midwife, who was interested and knowledgeable on baby's positioning throughout pregnancy, labor, and birth things could have been different. I probably should have opted for a homebirth considering the fear I had of the hospital. Glory was stuck in my pelvis forehead first. That is how they found her when they were performing the cesarean. That explains the meconium because that is a very stressful position for the baby and fetal stress has been linked with meconium being present in the amniotic fluid. Although, I believe that the cesarean was necessary in the moment I also believe that there were many things that could have been done prior to labor and during labor that might have changed her position when she dropped down into my pelvis.

I want more than ever for my baby to enter peacefully into my own arms. I want him/her to be comforted with my heartbeat and the sound of my voice. I want to be able to kiss my baby within the first few seconds of his/her life.

This is what I will change if and hopefully when I am faced with bringing my next child into this world.
1. I will find a midwife who 100% believes in a woman's body and the labor and birth process.
2. I will labor and attempt to birth my baby in a place where I feel safe.
3. I will hire a doula who is experienced and knowledgeable in positioning techniques.
4. I will eat right and exercise regularly.
5. I will get help from a chiropractor who is experienced with prenatal care, the full webster's technique, and myofascial release.
6. I will get help from an acupuncturist and also receive prenatal massages.
7. I will have good posture whether sitting or standing and will use what is recommended on Spinning Babies to get my baby in a favorable position from the start.
8. I will use water for pain relief and relaxation of my muscles during labor and possibly birth.
9. Most importantly I will keep an open mind, have patience with my body, and be proactive in my own experience by making informed decisions.

I honestly do think, giving what I know now, I could have avoided both cesareans. I have done a lot of work emotionally in order to get through the what ifs and could haves. I no longer have negative feelings about them. I actually have a huge amount of hope that comes along with the accepting of my past experiences. They are what they are, and cannot be changed. The future is wide open though, and I plan to give it all I have for my baby, for other women who need the inspiration, and for myself!

1 comment:

Becky, this is the most educated and heartfelt piece I've read from you EVER! It's beautiful.... your story spilled out of your fingers with passion. Thank you for sharing this. It really says a lot about the strong and passion-filled woman you are.